CERTIFIED ENROLLER COVERED
CALIFORNIA MIDTERM TEST PAPER 2026
COMPLETE QUESTIONS VERIFIED
ANSWERS HEALTH INSURANCE
ENROLLMENT TRAINING STUDY GUIDE
GRADED A+
⩥ Which state became the first state in the nation to enact legislation to
establish a health insurance marketplace after the passage of the ACA?
Answer: California
⩥ Can individuals still be penalized when they file their federal tax
returns for failing to have MEC (Minimum Essential Coverage)?
Answer: You will not be penalized by the federal government, BUT can
be through the state of California.
⩥ What is the eligibility criteria for consumers in a QHP (Qualified
Health Plan) through Covered CA include: Answer: - Be a citizen or
national of US or a non-citizen who is lawfully present in the US
- Be a resident (or intend to be a resident) of CA and
- Not incarcerated (other than incarceration pending the disposition or
judgement of charges)
,⩥ Do agents have to have a license with the California Department of
Insurance before they begin selling insurance? Answer: Yes, additionally
they must also become certified with Covered California
⩥ Certified Insurance Agents (CIA) earn and are paid commissions for
effectuated enrollments with: Answer: - Individual and Family Plans:
commissions are paid by Covered CA Qualified Health and Dental Plans
- Covered CA for Small business (CCSB): commissions are paid by
CCSB
⩥ Certified Application Counselor (CAC) provide in-person consumer
enrollment assistance and are largely represented by CBOs (Community
Based Organizations). Answer: These enrollment partners ARE NOT
compensated by Covered CA.
⩥ Navigator Grant Program- CEC (Certified Enrollment Counselor)
Answer: Provides outreach, education, enrollment assistance, and post-
enrollment services to consumers on behalf of Covered CA
⩥ What is considered SEP (Special Enrollment Period)? Answer:
Qualifying life events such as birth or adoptions, marriage, moving to or
within California, or loss of MEC (Minimum Essential Coverage)
⩥ To ensure that consumer assistance is accessible to people with
disabilities: Answer: -Provide enrollment resources, websites, and tools
that are accessible to individuals with disabilities
, - Provide assistance in a location and manner that is physically and
otherwise accessible
- Maintain knowledge to refer people with disabilities to long-term
services and support programs when appropriate
⩥ What age can children remain on their parent's health insurance plan?
Answer: Until they reach age 26
⩥ What are not subject to copayments, coinsurance, or deductibles?
Answer: - Preventative care, vaccinations, and medical screenings
- Mammograms and colonoscopies
- Wellness visits
- Gestational diabetes screening
- Additional preventative care and screenings are available to women
- Approved contraceptive methods
⩥ What is the difference between metal tiers? Answer: - Platinum-level
plans cover 90 percent of health care costs, and you pay 10 percent
- Gold plans cover 80 percent, while you pay 20 percent
- Silver plans cover 70 percent, while you pay 30 percent
- Bronze plans cover 60 percent, while you pay 40 percent.
⩥ What is a premium? Answer: The amount a consumer must pay their
health or dental plan, usually paid on a monthly basis.
CALIFORNIA MIDTERM TEST PAPER 2026
COMPLETE QUESTIONS VERIFIED
ANSWERS HEALTH INSURANCE
ENROLLMENT TRAINING STUDY GUIDE
GRADED A+
⩥ Which state became the first state in the nation to enact legislation to
establish a health insurance marketplace after the passage of the ACA?
Answer: California
⩥ Can individuals still be penalized when they file their federal tax
returns for failing to have MEC (Minimum Essential Coverage)?
Answer: You will not be penalized by the federal government, BUT can
be through the state of California.
⩥ What is the eligibility criteria for consumers in a QHP (Qualified
Health Plan) through Covered CA include: Answer: - Be a citizen or
national of US or a non-citizen who is lawfully present in the US
- Be a resident (or intend to be a resident) of CA and
- Not incarcerated (other than incarceration pending the disposition or
judgement of charges)
,⩥ Do agents have to have a license with the California Department of
Insurance before they begin selling insurance? Answer: Yes, additionally
they must also become certified with Covered California
⩥ Certified Insurance Agents (CIA) earn and are paid commissions for
effectuated enrollments with: Answer: - Individual and Family Plans:
commissions are paid by Covered CA Qualified Health and Dental Plans
- Covered CA for Small business (CCSB): commissions are paid by
CCSB
⩥ Certified Application Counselor (CAC) provide in-person consumer
enrollment assistance and are largely represented by CBOs (Community
Based Organizations). Answer: These enrollment partners ARE NOT
compensated by Covered CA.
⩥ Navigator Grant Program- CEC (Certified Enrollment Counselor)
Answer: Provides outreach, education, enrollment assistance, and post-
enrollment services to consumers on behalf of Covered CA
⩥ What is considered SEP (Special Enrollment Period)? Answer:
Qualifying life events such as birth or adoptions, marriage, moving to or
within California, or loss of MEC (Minimum Essential Coverage)
⩥ To ensure that consumer assistance is accessible to people with
disabilities: Answer: -Provide enrollment resources, websites, and tools
that are accessible to individuals with disabilities
, - Provide assistance in a location and manner that is physically and
otherwise accessible
- Maintain knowledge to refer people with disabilities to long-term
services and support programs when appropriate
⩥ What age can children remain on their parent's health insurance plan?
Answer: Until they reach age 26
⩥ What are not subject to copayments, coinsurance, or deductibles?
Answer: - Preventative care, vaccinations, and medical screenings
- Mammograms and colonoscopies
- Wellness visits
- Gestational diabetes screening
- Additional preventative care and screenings are available to women
- Approved contraceptive methods
⩥ What is the difference between metal tiers? Answer: - Platinum-level
plans cover 90 percent of health care costs, and you pay 10 percent
- Gold plans cover 80 percent, while you pay 20 percent
- Silver plans cover 70 percent, while you pay 30 percent
- Bronze plans cover 60 percent, while you pay 40 percent.
⩥ What is a premium? Answer: The amount a consumer must pay their
health or dental plan, usually paid on a monthly basis.
